OBJECTIVES: To evaluate the cost-effectiveness of dasatinib 100mg once daily in second-line therapy for Chronic Myeloid Leukaemia (CML) patients in the chronic phase (CP) resistant to imatinib 400mg compared with imatinib 800mg and nilotinib 800mg in Russia. METHODS: A Markov cost-utility model was developed to estimate life-time outcomes and resource use reflecting treatment practice for CML patients in Russia. Treatment efficacy, disease progression and rates of adverse events in the model were based on published multi-centre randomized controlled trials. RESULTS: Dasatinib appeared to be dominant over imatinib and nilotinib in CP-CML in the Russian setting. Incremental life expectancies were 0.17 years and 0.26 years when comparing dasatinib with imatinib and nilotinib respectively; quality-adjusted life years (QALYs) gains were of 0.18 and 0.22 QALY versus imatinib and nilotinib respectively. The life years and QALY gains on dasatinib treatment were due to a larger proportion of patients who achieved complete cytogenic response (CCyR). Mean cost saving per patient over a lifetime horizon with dasatinib were Rubles (RUB) 1,364,220 versus imatinib and RUB 778,621 versus nilotinib. Limitations of the model include a lack of direct comparative efficacy data at licensed doses, which precluded formal indirect comparison. CONCLUSIONS: Dasatinib was a dominating strategy, resulting in outcome gains (greater life expectancy and greater quality-adjusted life expectancy) and cost saving compared both to nilotinib and high-dose imatinib in CP-CML patients. Expanding access to new tyrosine kinase inhibitors for the treatment of CP-CML in Russia would ensure a greater choice of modern and effective therapies.